Casting

Congratulations! That stomach cramp is a full-term baby

By Diane Mapes

MSNBC- We all get busy at times, so overwhelmed with work, family, friends and obligations that we neglect our bodies. But how is it possible to be so out of touch with your body that you don’t know you’re about to give birth?

Easy, say the people involved with “I Didn’t Know I Was Pregnant,” a 10-episode reality TV show that tells the story of 10 women who conceive and carry babies full term without realizing they’re pregnant.

“I think at first glance you think, how could a woman not know,” says Wendy Douglas, director of production for the TLC network. “Clearly she’s not paying attention or not smart or something. But that’s really not the case.”

Pregnancy symptoms can really vary,” says Dr. Michelle Evans, a reproductive endocrinologist from Pasadena, Calif., who’s featured on the show. “Some women have very minimal or no symptoms. Other women will be throwing up every day.”A host of circumstances can contribute to a stealth pregnancy, say doctors, starting with the fact that not all women experience the familiar nausea, weight gain, swollen ankles, food aversions and emotional ups and downs we’ve come to associate with pregnancy.

Expectations can also come into play, say the experts. Some women will take a pregnancy test and receive a false negative. Or be told by their doctor they’re unable to conceive. Moms who’ve just delivered a baby often (mistakenly) believe it’s too soon to be pregnant; other women will be using birth control but for whatever reason – an expired condom, a missed pill, a course of antibiotics – the system will fail. Thinking there’s no way they could possibly be pregnant, these women will attribute their symptoms to something else – morning sickness becomes a bad bout with food poisoning, swollen ankles are due to all the time they spend on their feet. They’ll blame their weight gain on outside circumstances – stress from the job, the fact they recently quit smoking – or they simply won’t gain that much weight in the first place.

“Some women only gain 5 to 10 pounds in their pregnancy,” says Evans. “One woman on the show was taking all of these extra Pilates classes and working very hard at exercising because she was gaining weight and didn’t know why.”

Other women’s weight will go up and down so much on a normal basis that the extra pounds don’t seem all that strange.

But wouldn’t these moms feel their babies kick?

“Everyone should have some fetal movement during the latter half of their pregnancies but there’s absolutely a range,” says Dr. Karen Wells, an ob/gyn at the Center for Women’s Health at Evergreen Hospital in Kirkland, Wash. “If a woman is heavy she doesn’t feel things quite as much and if the placenta is in the front, right under the belly, and the baby is below that, that’s going to insulate it, too.”

But if a woman doesn’t believe she’s pregnant, the movement of a baby will often be attributed to something else, says Evans.

“They may think they have indigestion or that there’s something else going on that causes them to feel movement,” she says.

Even old standbys like a woman’s period – or lack thereof – can often prove to be unreliable indicators, say the experts.

“One of the things I saw in many of these cases was that the women had very irregular menstrualcycles,” says Evans, who studied the case histories of the women featured in the show. “Many were so irregular that their doctors told them ‘When you want to get pregnant, we’re going to have to help you because you’re not ovulating.’ So when they had symptoms during pregnancy, they attributed it to some other condition.”

Spotting – which often occurs during a woman’s pregnancy – was another factor that led to confusion. Women with irregular periods assumed an episode of spotting was simply their haphazard period showing up.

Psychological factors like fear and denial can also play a role in a “surprise” pregnancy.

“Our minds are our most powerful organs and there are people who really don’t want to be pregnant and convince themselves that they’re not,” says Wells. “This happened twice during my residency. One time, a woman was in labor and was sure she wasn’t pregnant even when the baby was crowning. Some people are in complete and total denial.”

Although doctors say going full-term without knowing you’re about to give birth is rare, TLC’s Douglas says she’s been inundated with stories of surprise pregnancies.

“Each time a show airs, we get a flood of letters from people saying ‘This happened to me!’ or “I know someone this happened to,’” she says. “I think right now we have well over 150 stories that we could tell.”

Indeed, the news is full of stories of stealth pregnancies. Last December, a British mother of two gave birth to a 5 pound, 8 ounce baby boy, who she claimed never kicked during the entire pregnancy. And in March of last year, 38-year-old Bonita Ewen of Oregon thought she was having stomach cramps, but instead gave birth to a 6 pound, 3 ounce baby boy out of the blue, telling reporters she had gained 10 pounds but experienced none of the “signs and symptoms of a pregnancy … no nausea, no cravings, none of that stuff.”

As in life, the unexpectant mothers featured in the show – which premiered September 30 –are from all walks of life. Some are in their late teens and early 20s, others are in their 40s (one woman was about to undergo a hysterectomy when doctors discovered she was on the verge of giving birth). Some have had children previously; others are new to the parenting game. One woman – who experienced no pregnancy symptoms whatsoever – tells the story of her two surprise deliveries, one at age 18 and another, three years later.

“Stealth moms” are found through e-mails and letters sent to the show’s producers following each episode and via the show’s Web site.

Albeit unexpected, the babies are all healthy although considering the lack of prenatal care – and in some cases, the use of birth control pills or other medications – there are potential health concerns. The mothers, while unprepared, are extremely excited about their surprise packages.

Since none of them knew they had a baby on the way, stories are told in flashback form, via interviews with the women and her friends and family (many of whom vouch for the mother’s incognizance or lack of symptoms) and a series of dramatic reenactments.

And it can be dramatic, says Evans, who’s seen a surprise birth in action.

“When I was a resident, I once saw a patient like this in the ER,” she says. “A woman came in and and the family thought she had appendicitis or something horrible. They thought she needed surgery. I evaluated her and did a pelvic and I could feel a head. I said, ‘Oh my gosh, we need to get her to labor and delivery right away’ and everyone’s jaw just dropped.”